Breadcrumbs

Author: Duncan Boak

Using Simulation to Understand your Business

In November 2017 the ICCESS team delivered a Sequential Simulation to a group of delegates from the UAE government undertaking a Public Sector Innovation Diploma with Imperial College Business School’s Executive Education Centre.

The simulation featured a re-enactment of a patient journey through the UK healthcare system. After watching the workshop, participants were encouraged to suggest improvements and draw parallels with their own work environments.

A fascinating video of the simulation has been released and can be viewed on YouTube:

Simulation for Learning: Faculti videos

Centre Director, Prof Roger Kneebone, was interviewed for a series of short videos for the Faculti.net website talking about ICCESS’ work in developing and using simulation for a variety of purposes, including surgical education. The videos can be viewed here: https://faculti.net/learning-simulated-environment/

Royal Academy Schools Guest Lecture

Professor Roger Kneebone recently gave a guest lecture at the Royal Academy of Arts, Burlington House. Prof Kneebone’s talk, part of the Royal Academy Schools lecture programme, focused on his interest in exploring the parallels between surgery and creative disciplines such as craft and performance.

Prof Roger Kneebone with present (and past?) members of the Royal Academy Schools team

The opportunity to gain first-hand insight into the challenges within the UK healthcare system might not be something that’s readily available outside Imperial College, and a group of newly enrolled students on the MSc International Health Management programme took full advantage when they visited the Centre for Engagement and Simulation Science (ICCESS) on 6 October.

The students watched a Sequential Simulation of a patient visiting hospital following a heart attack and undergoing a coronary angioplasty. The ICCESS team designed the simulation to show interactions between patients and clinicians in difficult circumstances; in this case due to a shortage of nursing staff. The student cohort, many of whom are from outside the UK and have no previous experience of the UK healthcare system, then worked in groups to discuss the challenges presented in the simulation and how things could be improved. (more…)

A conference delegate is talked through a demonstration of the device by Luc Maréchal

World Haptics is a major conference on technology that recreates the sense of touch, and is attended by research groups from the US, Japan, Korea and the UK, some of the leading countries behind this emergent branch of science.

Dr Fernando Bello and Dr Luc Maréchal of the SiMMS group within the Centre for Engagement and Simulation Science (ICCESS) attended the conference to showcase the latest developments of the Digital Rectal Examination Haptics Trainer (DiRECT) project. The team have been working on technology to simulate assessment of sphincter tone; very important to a clinician carrying out an examination on a patient, but something that is not currently part of any existing training device. Dr Bello and Dr Maréchal presented a poster with two different approaches to simulate sphincter tone, one using cables and the other employing a soft pneumatic actuator. They also demonstrated each prototype so that conference delegates could see – and feel – the technology for themselves. (more…)

Robot Surgery Live at the Science Museum

The celebrated Imperial surgeon Professor Lord Ara Darzi took a step back in time to the year 2000 to re-enact the UK’s first robot-assisted keyhole surgery operation on Friday 10 March at the Science Museum in London, as part of the museum’s current Robots exhibition

Using the UK’s first da Vinci surgical robot device (recently acquired by the Science Museum for its major new Medical Galleries, scheduled to open in 2019), Professor Darzi and his team demonstrated how he removed his patient’s gallbladder in that pioneering operation, controlling the surgical instruments remotely from a console on the other side of the operating theatre. (more…)

Sharing approaches to maternity services

The ICCESS team are partway through an innovative simulation-based research project to map maternity services across North West London. The Sharing Approaches to Maternity Services project, funded by Health Education North West London, aims to identify areas of best practice, challenges in the current system, and suggest ways in which services could be improved.

The project uses Sequential Simulation (SqS) to model the maternity care pathway (see image below). The simulation compresses the nine month pathway into a 30 minute simulation that is being delivered to maternity teams at six hospitals in the NW London region. (more…)

Asia Haptics 2016

The SiMMS group within the Centre for Engagement and Simulation Science (ICCESS) presented a paper at Asia Haptics 2016 relating to their haptic Digital Rectal Examination (DRE) Trainer. Asia Haptics features a new format that consists of interactive demonstrations presented over the two day duration of the conference, with a brief explanation of the work projected live on to the main viewing screen.

The SiMMS team presented a paper entitled ‘Relax and Tighten – a Haptics-based Approach to Simulate Sphincter Tone Assessment’. The haptic DRE Trainer uses metal wires, controlled by motors, to tighten and relax a silicone sphincter around the user’s finger. (more…)

Stand Up To Cancer

The SiMMS group within the Centre for Engagement and Simulation Science (ICCESS) had an important role in Channel 4’s Stand Up To Cancer telethon on Friday 14 October. The annual live TV event is a partnership between C4 and Cancer Research UK and features stars from film, music and television. The production company behind the 2016 event approached ICCESS after seeing recent media publicity about the Centre’s pioneering haptic device for rectal examinations.

Members of the team, led by Centre Director Dr Fernando Bello, duly took part in rehearsals and filming, setting up the device for TV presenter Davina McCall to get a lesson in direct rectal examination (DRE) from Dr Mike live on television!

The inclusion of the robotic rectum in the show helped make an important point. Embarrassment about rectal examination can be one reason why some men don’t visit the doctor even if they have symptoms that are indicative of prostate cancer. The SiMMS group are keen to explore ways in which their device can be used to help educate patients on the importance of rectal examination – and why it’s not worth dying of embarrassment.

Here’s a clip of Davina performing her first rectal examination…albeit on the robotic rectum: http://bit.ly/2gEzyf7

Wellcome Saturday Studio

A team of researchers, clinicians and educators from ICCESS delivered a highly successful workshop at the Wellcome Collection on Saturday 29 October. ‘Saturday Studio’ is a series of drop-in workshops for people aged 14-19 inspired by the Wellcome Collection and led by experts from a range of disciplines. The ICCESS team, led by Prof Roger Kneebone, delivered a hands-on session that explored the skills of surgery from an unusual perspective.

The three themes of the workshop covered some of the skills fundamental to surgery

Joining and sewing, led by lacemaker Fleur Oakes, demonstrated how delicate stitching and handiwork is key to many surgical procedures

Working in teams, featuring puppeteer and theatre director Rachel Warr, showed how puppets are moved and manipulated by several people working in tandem, highlighting the importance of collaboration in the operating theatre

Teaching your fingers to see, led by ICCESS researcher Dr Alejandro Granados, taught guests how the sense of touch is vitally important to clinicians when performing internal examinations

The event was extremely popular and received a great deal of positive feedback from the young people who attended, and the ICCESS team are hoping to go back to deliver another such session in future.

For more information about the Wellcome Collection Saturday Studio visit

Sir Philip Dilley visit to ICCESS

The Imperial College Centre for Engagement and Simulation Science (ICCESS) recently hosted a visit from Sir Philip Dilley, Chair of Imperial’s governing Council. Sir Philip learned of ICCESS’ work in combining medical simulation with innovative approaches to engagement after meeting Centre Director Prof Roger Kneebone at a reception at South Kensington earlier this year.

Sir Philip graduated from Imperial with a First in Civil Engineering in 1976, and spent much of his engineering career with the Arup Group where he was Executive Chairman from 2009 to 2014. ‘A lot has changed at Imperial College since the late 70’s,’ says Sir Philip, ‘and one of the most impressive changes is the amount of cross-departmental collaboration and research.’ Much of the work of ICCESS brings together diverse teams, in one case even exploring lacemaking techniques to learn how to better manage threads during complex surgery.

As part of the visit, Sir Philip got to try his hand at open abdominal surgery – albeit in simulated form! The experience opened his eyes to how powerful simulation can be. ‘My total immersion and focus on the surgical task at hand meant that I hadn’t noticed any of the other activities going on around me, let alone the wellbeing of the patient. And I’d only been given the ‘surgery-lite’ experience without gowns or blood.’

ICCESS at the North West London Simulation Conference

ICCESS played a major role at the North West London Simulation Conference on 21 September 2016. The conference brought together delegates with an interest in simulation delivery and development from a wide range of professions, including doctors, nurses, scientists and technicians.

Dr Tanika Kelay, Dr Miranda Kronfli and Sharon-Marie Weldon demonstrated some of ICCESS’ simulation equipment and environments including their ‘simbulance’ and catheterisation lab. Sharon and Miranda also delivered two workshops in which they demonstrated ICCESS’ approach to multi-disciplinary simulation through the use of Actor Network Theory with an emphasis on the design process itself, using some of their recent research to highlight how this differs from current practice. Centre Director Prof Roger Kneebone was one of the keynote speakers and explained how ICCESS are reframing simulation as a means of engaging with different audiences to drive innovation in healthcare.

The conference was very well-attended and the team reported that delegates found ICCESS’ work interesting and inspiring. The experience has generated a great deal of interest in the Centre’s ongoing projects with several new contacts who are keen to be involved thus building on ICCESS’s growing network of collaborators.

Simulation Reframed

A recent publication by Prof Kneebone provides further support for simulation as a powerful means of engaging with publics, patients and experts outside medicine. Simulation Reframed has been published in the Advances in Simulation journal and can be read here.

Duncan BoakCentre ManagerImperial College Centre for Engagement and Simulation Science

Imperial College London was the host of Eurohaptics 2016, the main international European conference for researchers in haptics and touch-enabled computer applications. The conference was held at South Kensington over 4-7 July 2016 and was organised by Imperial College London in partnership with University College London, University of Reading, University of Bristol and University of Birmingham.

Eurohaptics 2016 was a great opportunity for researchers – drawn from disciplines such as neuroscience, psychology and robotics – to meet and present their work with the goal of improving understanding of the sense of touch from a physiological and perceptual perspective, devising new haptic devices and investigating better ways of controlling and interacting with them.

Haptics is a growing field, with awareness amongst the wider public also on the rise thanks to the increasing use of haptic technology in mobile devices. Eurohaptics 2016 included public-focused evening events at the Royal Society and Royal Institution.

Imperial College’s Centre for Engagement and Simulation Science (ICCESS) played a leading role in the conference, with Centre Director Dr Fernando Bello as both Programme co-Chair and local co-Chair, and Dr Alejandro Granados-Martinez showcasing the haptic rectal examination trainer he has developed. His innovative device attracted a great deal of media coverage over the conference period, with articles in the Daily Telegraph, Daily Mail and Vice Magazine, to name a few.

Keynote speakers at Eurohaptics 2016 included Professor Stephen Brewster (University of Glasgow), Dr Henrik Jörntell (Lund University, Sweden) and Professor Blake Hannaford (University of Washington, USA), who acknowledged challenges in the design of haptic devices and how we could improve this by studying brain circuitry during tactile skin sensing and by enhancing the way we interact with them.

Eurohaptics 2016 was attended by nearly 400 delegates from 26 countries and was therefore the largest event in the history of the conference.

Haptic technology is a term that you might not be familiar with, although you probably make use of it on a daily basis. Haptics is the science of using the sense of touch to interact with computer applications, whether this is swiping the screen on your smartphone or using a sophisticated haptic simulator to practice a complex medical procedure.

ICCESS prototype haptic simulator for rectal examinations

Imperial College London is hosting Eurohaptics 2016, a major international conference on haptic technologies, on 4– 7 July. The conference is a partnership between a number of academic institutions and the Eurohaptics Society.

The Simulation and Modelling in Medicine and Surgery (SiMMS) research group, part of the Imperial College Centre for Engagement and Simulation Science (ICCESS), are participating in Eurohaptics 2016 and helping with its local organisation. Dr Fernando Bello, who leads the SiMMS group and is a joint Director of ICCESS, is Programme Co-chair and Local Co-chair.

One strand of ICCESS’ work is the research and development of pioneering haptic devices for clinical simulations. See https://www.imperial.ac.uk/simms/ for further information.

ICCESS researchers work closely with Eurohaptics sponsor, Generic Robotics (www.genericrobotics.com). The Centre’s collaboration with Generic Robotics is taking research developed at ICCESS through to commercialisation. Projects include a haptically enabled simulator for training surgeons to perform advanced endoscopic surgical procedures and a system for training clinicians to perform unsighted internal examinations.

In addition to showcasing the latest advances in haptics and bringing together world-renowned experts, Eurohaptics includes opportunities for the general public to learn and engage with this emergent technology through events at the Royal Institution and Royal Society.

The Ri Lates event ‘Touch and Go’ takes place on Friday 8 July. Visit the link below for more information and to book tickets.

ICCESS have once again been supporting the More Smiles Appeal, by delivering a simulation event at Wetherby Preparatory School on 2nd February 2016. Funds raised on the night will contribute towards the redevelopment and expansion of the paediatric intensive care unit at St Mary’s Hospital. The simulation featured a team of clinicians from the unit demonstrating the high level of care they provide despite the constraints they are placed under in terms of space.

ICCESS are pioneers of Sequential Simulation, which is the physical re-enactment of a patients care pathway through the healthcare system. It utilises real clinicians and clinical props to provide expertise and context to the issues being explored. ICCESS’ Sharon-Marie Weldon, who has developed the concept and successfully designed and delivered numerous simulation events, has seen first-hand how Sequential Simulation serves as a valuable means of engaging people with the world of medicine: ‘Sequential Simulation is a way of utilising the benefits of simulation to recreate aspects of care, but with a much wider scope, creating a juxtaposition of the healthcare system that can be used for a variety of objectives; education and training, evaluation, care re-design, quality improvement, and patient and public engagement – as we saw with the More Smiles Appeal event’.

To hear more about the More Smiles Appeal contact Maurice O’Connor on 02033125696 or to donate to the appeal, please visit www.moresmiles.org.uk

In November 2016, Professor Roger Kneebone was invited to participate in a 2-day colloquium in Bern, convened by the Swiss Federal Office of Public Health (FOPH) to formulate a national strategy for skills and simulation in health care in Switzerland. The colloquium brought together the University of Bern, the University of Applied Sciences Bern, the University of Health Sciences of the Canton of Vaud (HESAV), and the Bern Centre of Higher Education of Nursing.

As one of two invited international experts, Roger presented his perspective on simulation and health policy within the UK and internationally. This included research on hybrid, distributed and sequential simulation within Imperial’s Centre for Engagement and Simulation Science – work which has now become embedded in the curriculum of the Bern Centre of Higher Education of Nursing.

Clinical Research Fellow Laura Coates was recently invited to be a visiting speaker at the University of Alberta in Edmonton. Laura gave an hour-long Grand Round presentation to the whole of the surgical department, followed by meetings with a number of members of staff and a session with the University’s postgraduate surgical students. Laura talked about some of ICCESS’ public engagement work, including events focusing on the effects of knife crime and the recent Time Travelling Operating Theatre that featured in last month’s FoM newsletter. Laura’s visit was very well-received, with staff and students commenting on the interesting and unusual nature of ICCESS’ work.

PhD Viva Success

Two of ICCESS’ students, Alejandro Granados-Martinez and Przemyslaw Korzeniowski, have successfully defended their PhDs on consecutive days. Their respective work on ‘Modelling and Simulation of Flexible Instruments for Minimally Invasive Surgical Training in Virtual Reality’ and ‘Haptics-based Simulation Tools for Teaching and Learning Digital Rectal Examinations’ was highly praised by the examiners, with only very minor corrections to be made to their dissertations.

Imperial College’s Centre for Engagement and Simulation Science (ICCESS) took their ‘Time-Travelling Operating Theatre’ project on the road in September and October 2015 to great acclaim. The project, funded by the Wellcome Trust, featured real clinicians working together in re-enactments of three eras of surgical history – 1884, 1984 and 2014. Members of the public were taken on a time-travelling journey through each era to see how technological, cultural, environmental and social changes have influenced the development of surgery.

Led by Sharon-Marie Weldon, the ICCESS team delivered the events at a number of prestigious venues; the Science Museum and Royal College of Nursing in London, the Thackray Medical Museum in Leeds and finally the National Museum of Scotland in Edinburgh. The events were very popular with the public and attracted a diverse audience.

The key aim of the project went beyond the delivery of the events, however. Research has shown that it is very difficult to engage the general public in debate that can shape healthcare policy. Each Time-Travelling Operating Theatre event was followed by a discussion amongst audience members, clinicians and others such as ethicists and medical defence lawyers. Some really interesting perspectives emerged from these discussions that covered a wide range of issues, from the ethics of modern medical procedures through to the environmental impact of the present-day healthcare system. Sharon-Marie is currently analysing the data that was captured from these discussions and will be producing a paper that examines whether hands-on engagement activities such as this represent the future of ensuring public involvement in shaping the future of healthcare.

The Imperial College Centre for Engagement and Simulation Science (ICCESS) were recently involved in the highly successful launch of a Charity of the Year partnership between the Children’s Intensive Care Unit Appeal and Home House, a private member’s club on Portman Square.

ICCESS delivered a simulation involving staff from St Mary’s Paediatric Intensive Care Unit (PICU) to demonstrate how the unit delivers world-class care despite being under considerable constraints in terms of space. The appeal will raise money to expand the facility and create additional 7 ICU beds within the PICU.

“I attended an event to announce the campaign for a new paediatric intensive care unit for St. Mary’s Hospital in London. It was, possibly, the most effective and moving such event, I have ever attended. The doctors from St. Mary’s and others acted out scenes from the paediatric ICU, complete with anxious parents and doctors speaking to them. There was a child in a hospital bed, and the attending physician explained his dire medical situation and articulated his needs, medical and emotional. The doctor spoke with disarming candour. It was tough going to see this performance, very different from the usual speeches and videos more typical of elegant fundraisers and campaign launches.” Feedback from a guest.

The experience of the ICCESS team in delivering realistic medical simulations to engage and move audiences combined perfectly with the passion and dedication of the PICU staff members who participated in the event. The audience, which included Imperial College Healthcare NHS Trust staff including Chief Executive Tracey Batten, members of Home House and special guests from appeal committee, found the evening inspirational and emotional. An important event for a very vital unit within St Mary’s Hospital and an significant milestone in this fundraising appeal.